Cervical cancer is one of the most common malignancies and is associated with a dismal prognosis. The most common therapeutic option for cervical cancer consists of surgery in early stages, and chemotherapy or radiotherapy in more advanced stages of the disease. Although treatment options have increased for some patients, overall progress has been modest. The mechanism of clinical antitumor drugs can mainly be summarized as a cancer cell DNA replication inhibition process that leads to apoptosis. There is a lack of in-depth system research in another important signal path, such as autophagy, for anti-cancer treatments.
Garcinia species (Family Guttiferae) are tropical evergreen trees and shrubs that are widely distributed in Southeastern Asia and their phytochemistry has been widely studied. Classic and caged xanthones have been isolated from various parts of these plants, and identified as their major bioactive components. Traditionally, Garcinia resin (called gamboge) has been used in folk and Chinese medicine to promote detoxification, treat inflammation and wounds. Furthermore, recently xanthones isolated from various Garcinia species also showed antibacterial, antioxidant, antiviral and neuroprotective effects.
Gambogic acid, a caged xanthone found at high concentrations in gamboge, has been involved in the injectable antitumor drug since the 1970s. In 2004, gambogic acid has been granted permission for testing in clinical trial as a wide spectrum antitumor drug. Gambogic acid and its derivatives are cytotoxic in many cancer cell lines by binding to the transferrin receptor and induction of G2/M cell cycle arrest and mitochondrial and death receptor-mediated apoptosis. Gambogic acid also reduces invasion and angiogenesis, telomerase mRNA expression and activity and tumor volume in vivo. However, the antitumor effect of gambogic acid can induce toxicity to the liver and kidney, which limits its development into a clinically useful anticancer drug.
Due to the toxicity of gambogic acid and other existing cancer treatments, there is a need to develop new anti-cancer treatments that possess selective cytotoxicity to cancers with low toxicity.
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